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1. Interim Guidance: Pre-exposure Prophylaxis (PrEP) for the Prevention of HIV Infection in Men Who Have Sex with Men

CDC issues interim guidance to health care providers on the use of PrEP as an HIV prevention strategy among men who have sex with men (MSM). In November 2010, the National Institutes of Health announced trial results providing the first evidence that daily oral use of an antiretroviral drug (TDF/FTC, brand name Truvada) used to treat HIV can also help to prevent sexually-acquired HIV among MSM when delivered as a part of comprehensive HIV prevention services. To help ensure safe and effective use of PrEP, CDC is currently leading national efforts to develop formal U.S. Public Health Service guidelines on its use among MSM. Until those more detailed guidelines are available, CDC is providing interim guidance to help inform clinical practice. CDC underscores the importance of targeting PrEP to MSM at high-risk for HIV acquisition and delivering it as a part of comprehensive HIV prevention services, which should include risk-reduction and medication adherence counseling, condoms, and testing and treatment for other sexually-transmitted infections. The guidance stresses the need to ensure any MSM who may be prescribed PrEP are confirmed to be HIV negative prior to use, as well as the need for regular monitoring of HIV status, side effects, adherence, and risk behavior among those taking PrEP. The guidelines only apply to MSM, as no data are available on its effectiveness among other populations.

2. Pediatric Lead Poisoning Associated with Use of a Cambodian Amulet

CDC Division of News and Electronic Media(404) 639-3286

Educational efforts are needed to inform Southeast Asian immigrants that amulets can be a source of lead poisoning. Lead poisoning in children is a preventable public health problem that can adversely affect the developing nervous system and result in learning and behavior problems. The most common source of exposure for lead-poisoned children aged <6 years in the United States is lead-based paint. However, non-paint sources have been identified increasingly as the cause of lead poisoning, particularly in immigrant communities. Health-care providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations. Health-care providers should ask parents about their use of amulets, especially Southeast Asian families and those with children with elevated blood lead levels (BLLs).

Teenagers who are ages 16-18 years should make sure they get either a booster dose or their first dose of meningococcal conjugate vaccine to protect against meningococcal disease. Meningococcal conjugate vaccines were licensed in 2005 based on immunogenicity (because a surrogate of protection had been defined) and safety data. After licensure, additional data on bactericidal antibody persistence, trends in meningococcal disease epidemiology in the United States, and vaccine effectiveness have indicated many adolescents might not be protected for more than 5 years. Therefore, persons immunized at age 11–12 years may have decreased protective immunity by ages 16 through 21 years, when their risk for disease is greatest. This report summarizes two recommendations approved by ACIP: 1) routine vaccination of adolescents, preferably at age 11 or 12 years, with a booster dose at age 16 years and 2) a 2-dose primary series administered 2 months apart for persons aged 2 through 54 years with persistent complement component deficiency (e.g., C5-C9, properidin, factor H, or factor D) and functional or anatomic asplenia.